How much rates vary
Facilitymedian $3,981 · 10th to 90th $525 to $14,125Professionalmedian $1,445 · 10th to 90th $1,122 to $2,239
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,348.96 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,348.96 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $6,606.93 Typical High $14,125.38 | Facility | None | $3,311.31 | $6,606.93 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,584.89 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $6,309.57 Typical High $17,782.79 | Facility | None | $660.69 | $6,309.57 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,122.02 | $2,187.76 |
Hometown Health Setting Professional Modifier None Typical Low $16.60 Median $1,348.96 Typical High $2,041.74 | Professional | None | $16.60 | $1,348.96 | $2,041.74 |
Hometown Health Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $1,737.80 | Professional | None | $14.45 | $14.45 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $4,265.80 | Facility | None | $1,174.90 | $1,174.90 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
United Setting Facility Modifier None Typical Low $302.00 Median $794.33 Typical High $2,951.21 | Facility | None | $302.00 | $794.33 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,412.54 | $2,089.30 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $676.08 Typical High $831.76 | Professional | 52 · Reduced service | $676.08 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,174.90 |
Where Nevada sits
The same service costs 14.0 times more in Maine than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
ME $28,122MD $2,008
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.